Reply To: my rituxin experience

Lori: I will ask my physical therapist on Thursday if there is some reference that will describe the exercise sequence more clearly than I can (below). His experience comes from treating patients with nerve damage from MS or diabetes. I wrote earlier about the theory that other, less damaged, nerves may be able to compensate for the loss of signal from the usual balance-assisting nerves – but this process of re-training the brain is repetitive and SLOW (“proprioperception”).

I started weekly PT sessions last June. Early exercises did not involve walking, rather stepping carefully up and down, and sideways up-and-down, first onto a wood step, than onto a stiff foam pad (both about 2 inches high) while holding on to a horizontal wall bar for security. (At home I use thick books for a step, and the handles of my exercise bike instead of a wall bar). At that time, when I walked holding a hand, I would frequently be grabbing on hard when I lost my balance. Learning those steps up and down slowly improved my balance, and we moved on to exercises involving various walking steps, still holding one hand for security. For a while, we tried stepping sideways in the 12″ squares formed by a rope ladder laid on the ground, but soon switched to walking exercises with emphasis on posture and NOT looking down at my feet. First series was sideways “step-close”; one foot sideways, then bring the other to it.

Then we moved on in February to more fluid walking sequences: (a) forwards, first with feet a few inches apart for stability, but later trying to place each foot in front of the other (like a model on a catwalk ! ) always looking up ahead not down. (b) “grapevine” or “fishtail” sideways motion with legs crossing over – except in my case I am limited in one crossover by an artificial hip which must not be distorted by crossing that leg too far (c) backwards – the most difficult – not with feet in a straight line, at least not yet.

All of this is done SLOWLY. It’s easier to do it fast when lurching from one leg to another. Doing the exercises slowly requires that I am balanced at all times.

The improvement in my balance has been slow but steady. I still use a held hand for security, but pull on it less often and more gently as I am able to correct my balance more on my own.

Lastly – there’s a social and mood benefit from weekly physical therapy sessions. It makes me feel positively involved in my own recovery process.

Ann